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Global, regional, and national burden and trends of neonatal encephalopathy

Pediatric Research (2026)Cite this article

Abstract

Background

Neonatal encephalopathy (NE) is a leading cause of neonatal mortality and disability. The study aims to analyze the condition’s global burden and temporal trends.

Methods

Data were extracted from the Global Burden of Disease (GBD) 2021 database, mainly on the cases and rate of prevalence, disability-adjusted life years (DALYs), and deaths of NE from 1991 to 2021. We analyzed prevalence, DALYs, and mortality at different levels. Trends were quantified using percentage change and estimated annual percentage change (EAPC).

Results

Globally, the prevalence of NE has increased from 1991 to 2021, while DALYs and deaths rates decreased. Low Socio-Demographic Index (SDI) regions had the highest prevalence cases in 2021 (15432, 95%UI: 12884–18173). The largest increase of prevalence occurred in South Asia over 31 years, with an EAPC of 2.11 (95%CI: 1.99–2.22). Ethiopia exhibited the largest increase in prevalent cases and rates, with a percentage of 248.51% and an EAPC of 3.56 (95%CI: 3.33–10.92). The burden of NE was consistently higher in males than in females.

Conclusion

Despite global improvements in DALYs and mortality, the increasing prevalence of NE in certain regions highlights the need for targeted public health strategies, particularly in low SDI regions.

Impact Statement

  • We estimated the temporal trends of prevalence, disability-adjusted life years (DALYs), and death following neonatal encephalopathy (NE).

  • The results demonstrated that NE increased, while DALYs and death decreased globally from 1991 to 2021.

  • The prevalence, DALYs, and death rates for NE exhibited a negative correlation with the Socio-Demographic Index (SDI), suggesting a progressive reduction in disease burden as regional socioeconomic conditions improve.

  • Targeted public health strategies are required to implemented in different SDI regions, improving the burden of NE.

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Fig. 1: Temporal trend of neonatal encephalopathy burden in global and 5 SDI regions.
Fig. 2: Prevalence rate per 100,000 population of neonatal encephalopathy in GBD regions in 1991 and 2021.
Fig. 3: Temporal trend of neonatal encephalopathy burden globally.
Fig. 4: Temporal trend of neonatal encephalopathy burden for different sexes.
Fig. 5: The associations between the SDI and prevalent rates of neonatal encephalopathy across 21 GBD regions.

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Data availability

The data and relevant analyses in this study were available in the online sources of the GBD 2021 database. (https://vizhub.healthdata.org/gbd-results/).

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Acknowledgements

The authors appreciate the works of the GBD Study 2021 collaborators. No financial assistance was received.

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Authors and Affiliations

  1. Neonatal medical center, Children’s Hospital of Fudan University/National Children’s Medical Center/National Health Commission Key Laboratory of Neonatal Diseases, Shanghai, China

    Ling Zhao, Yingying Jiang, Zhuoyu Zhao & Laishuan Wang

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  1. Ling Zhao
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  2. Yingying Jiang
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  3. Zhuoyu Zhao
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  4. Laishuan Wang
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Contributions

Z.L. contributed to the conception and design of the study, statistical analysis, and drafting the manuscript. J.Y.Y. and Z.Z.Y. contributed to the methodology and statistical analysis. W.L.S. contributed to the conception and supervision, and revised and commented on the draft. This study was completed with the assistance and approval of all authors.

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Correspondence to Laishuan Wang.

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Zhao, L., Jiang, Y., Zhao, Z. et al. Global, regional, and national burden and trends of neonatal encephalopathy. Pediatr Res (2026). https://doi.org/10.1038/s41390-025-04582-0

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